Alcohol
use disorder
Overview
Alcohol use disorder is a
pattern of alcohol use that involves problems controlling your drinking, being
preoccupied with alcohol, or continuing to use alcohol even when it causes
problems. This disorder also involves having to drink more to get the same effect
or having withdrawal symptoms when you rapidly decrease or stop drinking.
Alcohol use disorder includes a level of drinking that's sometimes-called
alcoholism.
Unhealthy alcohol use
includes any alcohol use that puts your health or safety at risk or causes
other alcohol-related problems. It also includes binge drinking — a pattern of
drinking where a male has five or more drinks within two hours, or a female has
at least four drinks within two hours. Binge drinking causes significant health
and safety risks.
If your pattern of drinking
results in repeated significant distress and problems functioning in your daily
life, you have alcohol use disorder. It can range from mild to severe. However,
even a mild disorder can escalate and lead to serious problems, so initial
treatment is important.
Symptoms
Alcohol use disorder can be
mild, moderate, or severe, based on the number of symptoms you experience.
Signs and symptoms may include:
Being unable to limit the
amount of alcohol you drink
Wanting to cut down on how
much you drink or making unsuccessful attempts to do so
Spending a lot of time
drinking, getting alcohol, or recovering from alcohol use
Feeling a strong craving or
urge to drink alcohol
Failing to fulfill major
obligations at work, school or home due to repeated alcohol use
Continuing to drink alcohol
even though you know it's causing physical, social, work or relationship
problems
Giving up or reducing social
and work activities or hobbies to use alcohol
Using alcohol in situations
where it's not safe, such as when driving or swimming
Developing a tolerance to
alcohol so you need more to feel its effect, or you have a reduced effect from
the same amount
Experiencing withdrawal
symptoms — such as nausea, sweating and shaking — when you don't drink, or
drinking to avoid these symptoms
Alcohol use disorder can
include periods of being drunk (alcohol intoxication) and symptoms of
withdrawal.
Alcohol intoxication results
as the amount of alcohol in your bloodstream increases. The higher the blood
alcohol concentration is, the more likely you are to have adverse effects.
Alcohol intoxication causes behavior problems and mental changes. These may
include inappropriate behavior, unstable moods, poor judgment, slurred speech,
problems with attention or memory, and poor coordination. You can also have
periods called "blackouts," where you don't remember events. Extremely
high blood alcohol levels can lead to coma, permanent brain damage or even
death.
Alcohol withdrawal can occur
when alcohol use has been heavy and prolonged and is then stopped or reduced.
It can occur within several hours to 4 to 5 days later. Signs and symptoms
include sweating, rapid heartbeat, hand tremors, problems sleeping, nausea and
vomiting, hallucinations, restlessness and agitation, anxiety, and occasionally
seizures. Symptoms can be severe enough to impair your ability to function at
work or in social situations.
What is considered 1
drink?
The National Institute on
Alcohol Abuse and Alcoholism defines one standard drink as any one of these:
12 ounces (355 milliliters)
of regular beer (about 5% alcohol)
8 to 9 ounces (237 to 266
milliliters) of malt liquor (about 7% alcohol)
5 ounces (148 milliliters)
of wine (about 12% alcohol)
1.5 ounces (44 milliliters)
of hard liquor or distilled spirits (about 40% alcohol)
When to see a doctor
If you feel that you
sometimes drink too much alcohol, or your drinking is causing problems, or if
your family is concerned about your drinking, talk with your health care
provider. Other ways to get help include talking with a mental health
professional or seeking help from a support group such as Alcoholics Anonymous.
Because denial is common,
you may feel like you don't have a problem with drinking. You might not
recognize how much you drink or how many problems in your life are related to
alcohol use. Listen to relatives, friends, or co-workers when they ask you to
examine your drinking habits or to seek help. Consider talking with someone who
has had a problem with drinking but has stopped.
If your loved one needs help
Many people with alcohol use
disorder hesitate to get treatment because they don't recognize that they have
a problem. An intervention from loved ones can help some people recognize and
accept that they need professional help. If you're concerned about someone who
drinks too much, ask a professional experienced in alcohol treatment for advice
on how to approach that person.
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Causes
Genetic, psychological, social,
and environmental factors can impact how drinking alcohol affects your body and
behavior. Theories suggest that for certain people drinking has a different and
stronger impact that can lead to alcohol use disorder.
Over time, drinking too much
alcohol may change the normal function of the areas of your brain associated
with the experience of pleasure, judgment, and the ability to exercise control
over your behavior. This may result in craving alcohol to try to restore good
feelings or reduce negative ones.
Risk factors
Alcohol use may begin in the
teens, but alcohol use disorder occurs more frequently in the 20s and 30s,
though it can start at any age.
Risk factors for alcohol use
disorder include:
Steady drinking over
time. Drinking too much on a regular basis for an
extended period or binge drinking on a regular basis can lead to
alcohol-related problems or alcohol use disorder.
Starting at an early
age. People who begin drinking — especially binge drinking —
at an early age are at a higher risk of alcohol use disorder.
Family history. The
risk of alcohol use disorder is higher for people who have a parent or other
close relative who has problems with alcohol. This may be influenced by genetic
factors.
Depression and other
mental health problems. It's common for people
with a mental health disorder such as anxiety, depression, schizophrenia or
bipolar disorder to have problems with alcohol or other substances. For these people, alcohol can be a form of
self-medication.
History of trauma.
People with a history of emotional trauma or other trauma are at increased risk
of alcohol use disorder.
Having bariatric
surgery. Some research studies indicate that having
bariatric surgery may increase the risk of developing alcohol use disorder or
of relapsing after recovering from alcohol use disorder.
Social and cultural
factors. Having friends or a close partner who
drinks regularly could increase your risk of alcohol use disorder. The
glamorous way that drinking is sometimes portrayed in the media also may send
the message that it's OK to drink too much. For young people, the influence of
parents, peers and other role models can impact risk.
Complications
Alcohol depresses your
central nervous system. In some people, the initial reaction may feel like an
increase in energy. But as you continue to drink, you become drowsy and have
less control over your actions.
Too much alcohol affects
your speech, muscle coordination and vital centers of your brain. A heavy
drinking binge may even cause a life-threatening coma or death. This is of
particular concern when you're taking certain medications that also depress the
brain's function.
Impact on your safety
Excessive drinking can
reduce your judgment skills and lower inhibitions, leading to poor choices and
dangerous situations or behaviors, including:
Motor vehicle accidents and
other types of accidental injury, such as drowning
Relationship problems
Deficient performance at
work or school
Increased likelihood of
committing violent crimes or being the victim of a crime
Legal problems or problems
with employment or finances
Problems with other
substance use
Engaging in risky, unprotected
sex, or experiencing sexual abuse or date rape
Increased risk of attempted
or completed suicide
Impact on your health
Drinking too much
alcohol on a single occasion or over time can cause
health problems, including:
Liver disease.
Heavy drinking can cause increased fat in the liver (hepatic steatosis) and
inflammation of the liver (alcoholic hepatitis). Over time, heavy drinking can
cause irreversible destruction and scarring of liver tissue (cirrhosis).
Digestive problems.
Heavy drinking can result in inflammation of the stomach lining (gastritis), as
well as stomach and esophageal ulcers. It can also interfere with your body's
ability to get enough B vitamins and other nutrients. Heavy drinking can damage
your pancreas or lead to inflammation of the pancreas (pancreatitis).
Heart problems.
Excessive drinking can lead to high blood pressure and increases your risk of
an enlarged heart, heart failure or stroke. Even a single binge can cause
serious irregular heartbeats (arrhythmia) called atrial fibrillation.
Diabetes
complications. Alcohol interferes with the release of
glucose from your liver and can increase the risk of low blood sugar
(hypoglycemia). This is dangerous if you have diabetes and are already taking
insulin or some other diabetes medications to lower your blood sugar level.
Issues with sexual
function and periods. Heavy drinking can cause
men to have difficulty maintaining an erection (erectile dysfunction). In
women, heavy drinking can interrupt menstrual periods.
Eye problems. Over
time, heavy drinking can cause involuntary rapid eye movement (nystagmus) as
well as weakness and paralysis of your eye muscles due to a deficiency of
vitamin B-1 (thiamin). A thiamin deficiency can result in other brain changes,
such as irreversible dementia, if not promptly treated.
Birth defects.
Alcohol use during pregnancy may cause miscarriage. It may also cause fetal
alcohol spectrum disorders (FASDs). FASDs can cause a child to be born with
physical and developmental problems that last a lifetime.
Bone damage.
Alcohol may interfere with making new bone. Bone loss can lead to thinning
bones (osteoporosis) and an increased risk of fractures. Alcohol can also
damage bone marrow, which makes blood cells. This can cause a low platelet
count, which may result in bruising and bleeding.
Neurological
complications. Excessive drinking can affect your nervous
system, causing numbness and pain in your hands and feet, disordered thinking,
dementia, and short-term memory loss.
Weakened immune
system. Excessive alcohol use can make it harder for
your body to resist disease, increasing your risk of various illnesses,
especially pneumonia.
Increased risk of
cancer. Long-term, excessive alcohol use has been
linked to a higher risk of many cancers, including mouth, throat, liver,
esophagus, colon, and breast cancers. Even moderate drinking can increase the
risk of breast cancer.
Medication and
alcohol interactions. Some medications interact with
alcohol, increasing its toxic effects. Drinking while taking these medications
can either increase or decrease their effectiveness or make them dangerous.
Prevention
Early intervention can
prevent alcohol-related problems in teens. If you have a teenager, be alert to
signs and symptoms that may indicate a problem with alcohol:
Loss of interest in
activities and hobbies and in personal appearance
Red eyes, slurred speech,
problems with coordination and memory lapses
Difficulties or changes in
relationships with friends, such as joining a new crowd
Declining grades and
problems in school
Frequent mood changes and
defensive behavior
You
can help prevent teenage alcohol use:
Set a good example with your
own alcohol use.
Talk openly with your child,
spend quality time together and become actively involved in your child's life.
Let your child know what
behavior you expect.
Jan Ricks Jennings, MHA,
LFACHE
Senior Consultant
Senior Management Resources,
LLC
724.733.0509 Office
412,913.0636 Cell
August 23, 2022
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